Insulin administration - Yeovil District Hospital NHS Foundation Trust

5.1 The section on self medication within the Trust’s Medicines Management Policy
must be adhered to; this includes appropriate, documented assessment of the
patient for suitability for self medication. The patients ability to self medicate may
alter several times during one admission and this should be documented on the
assessment.
5.2 Any proposed changes made to patients’ insulin doses should be communicated to
the patient immediately.
5.3 Some patients may give variable doses of quick acting insulin and adjust doses of
longer acting insulin. The Insulin prescription chart should reflect this practice.
5.4 Illness and admission to hospital are stressful events and blood glucose levels may
rise as a result. Patients who are used to adjusting their own insulin doses should
be encouraged to continue to do so as necessary.
5.5 If patients are not mobile enough to access a ward sharps container they should be
provided with a 1 litre sharps container at the bedside, in order to minimise the risk
of sharps accident.
6. Mixing insulin
6.1 Many of the commonly used insulins are premixed e.g. Novo Mix 30. Some older
insulin regimens involve the mixing of two different insulins in a syringe prior to
administration. Soluble, or short acting insulins, such as Humulin S or Actrapid,
and rapid acting insulins, such as Humalog or NovoRapid, must only be mixed
with an isophane insulin, such as Humulin I or Insulatard.
6.2 Under no circumstances should soluble insulins be mixed with Levemir or
Lantus, or insulin zinc suspensions e.g. Hypurin Bovine Protamine Zinc.
6.3 Insulin suspensions (cloudy insulins) must be mixed thoroughly by gently rolling -
not vigorously as this will destroy the insulin molecule before drawing up. Contact
the Diabetes Department on ext 4517 should you need further advice before
mixing or giving insulins.
7. Insulin delivery devices
7.1 Subcutaneous insulin must be delivered via insulin syringes or with a commercial
Insulin pen. Under no circumstances must intravenous syringes be used to
measure and administer insulin doses.
7.2 The standard insulin syringe used by the Trust is the BD 0.5 ml insulin syringe with
an integrated 8mm needle. The ‘twin bin’ service will ensure that each clinical area
has a sufficient supply of insulin syringes. (These must be stored separately from
the 1ml IV syringes). Insulin pen needles can be obtained from pharmacy.
7.3 Commercial insulin pens are available on prescription for people with diabetes
using insulin therapy. If a patient starts insulin treatment whilst in hospital the
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